Nursing and Public Health

Piel. Zdr. Publ.
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ISSN 2082-9876 (print)
ISSN 2451-1870 (online)
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Pielęgniarstwo i Zdrowie Publiczne Nursing and Public Health

2019, vol. 9, nr 2, April-June, p. 107–112

doi: 10.17219/pzp/102439

Publication type: review article

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Bile acids and their role in functional gastrointestinal disorders

Kwasy żółciowe i ich rola w zaburzeniach czynnościowych przewodu pokarmowego

Radosław Andrzej Konieczny1,B,C,D, Wojciech Różański1,B,C, Elżbieta Poniewierka2,A,E,F, Radosław Kempiński2,C,E,F, Katarzyna Neubauer3,E,F

1 Clinic of Gastroenterology and Hepatology, Jan Mikulicz-Radecki University Teaching Hospital, Wrocław, Poland

2 Department and Clinic of Gastroenterology and Hepatology, Wroclaw Medical University, Wrocław, Poland

3 Division of Dietetics, Department and Clinic of Gastroenterology and Hepatology, Wroclaw Medical University, Wrocław, Poland

Abstract

Studies of the role of bile acids have been conducted for many years. Thanks to constantly improving research methods, the systemic action of bile acids has been evaluated with increasing precision. It is now believed that disturbances in the synthesis, transformation and transport of bile acids may be one of the causes of functional bowel disorders. Constant renewal of the bile acid pool and secretion of bile acids into the gastrointestinal lumen is regulated by feedback loops. Bile acids play the role of signaling molecules by binding to the appropriate receptors and influencing the synthesis of other signaling molecules at the cellular level. Disturbances of synthesis, reabsorption and changes in the proportion of bile acids all lead to motor dysfunction and intestinal secretion. The most common symptoms are diarrhea, constipation or irritable bowel syndrome. This article discusses the basic issues of the synthesis and circulation of bile acids. On the basis of in vitro and in vivo findings, an outline of the regulation of physiological processes and the pathophysiology of diarrhea and constipation in the context of bile acids is presented. Understanding the role of bile acids in the pathophysiology of functional intestinal diseases creates new therapeutic options for patients suffering from functional diarrhea or constipation.

Streszczenie

Badania dotyczące roli kwasów żółciowych są prowadzone od wielu lat. Dzięki stale udoskonalanym metodom badawczym udaje się coraz precyzyjniej oceniać działanie systemowe kwasów żółciowych. Obecnie uważa się, że zaburzenia syntezy, przemian i transportu kwasów żółciowych mogą być jedną z przyczyn czynnościowych zaburzeń jelit. Stałe odnawianie puli kwasów żółciowych oraz ich sekrecja do światła przewodu pokarmowego podlegają regulacji na zasadzie sprzężeń zwrotnych. Kwasy żółciowe pełnią rolę cząsteczek sygnałowych, wiążąc się z odpowiednimi receptorami i wpływając na syntezę innych cząsteczek sygnałowych na poziomie komórkowym. Zarówno zaburzenia syntezy, reabsorpcji, jak i zmiany proporcji kwasów żółciowych prowadzą do zaburzeń motoryki oraz sekrecji jelitowej. Najczęstszymi objawami są biegunka, zaparcie lub zespół jelita nadwrażliwego. W artykule omówiono podstawowe zagadnienia dotyczące syntezy oraz krążenia kwasów żółciowych. Na podstawie wniosków z badań in vitro oraz in vivo przedstawiono zarys regulacji procesów fizjologicznych oraz patofizjologię możliwych przyczyn biegunki i zaparć w kontekście działania kwasów żółciowych. Poznanie roli kwasów żółciowych w patofizjologii czynnościowych chorób jelit stwarza nowe możliwości terapeutyczne dla chorych na biegunkę i zaparcia czynnościowe.

Key words

bile acids, constipation, peristalsis, diarrhea

Słowa kluczowe

kwasy żółciowe, zaparcie, biegunka, perystaltyka

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